Steve Calvin M.D. on pregnancy care, health care reform, and innovation

Excitement at the Minnesota Birth Center

Just over a year ago mothers started having babies at the Minnesota Birth Center (MBC).  Tanya, Martha, and Mary-Signe provide great midwifery care along with their talented nursing colleagues.   More than one hundred mothers and fathers have welcomed their new daughters and sons in the birthing rooms.  We are now at capacity and have a waiting list.  Two of the little newborn girls were my granddaughters Hazel and Sigrid.   Their moms chose the MBC without any pressure from me and they were both birthing champs.

As medical director I  am not supposed to play a role in the birth of babies at the MBC.  That is the natural domain of the midwives.   They do it really well.   I have only been present for one of the births at the center.  It was very exciting and had a happy ending.   It started with an urgent late night call to come down to the center ASAP.  A second time mother was very close to delivery and after the membranes ruptured it became clear the the baby was in a breech presentation.

This was one of those OB surprises that sometimes happens.  Since she was completely dilated the baby was coming very soon and transfer to the hospital was not an option.  It took me 10 minutes to join the crowd at the center (another mom was giving birth at the same time).  Over the last decade in the US  breech births have almost exclusively been accomplished by cesarean section.  This is due to a slight (though real) increase in risk to the baby – because the head is the largest and last part of the baby to be born.  The pros and cons of vaginal breech delivery will have to wait until another post.

Anyway, this baby was arriving any minute.  I thought through the situation and (as always) contemplated the worst possible outcomes.  Being certain that preparation will ward off disaster I asked if someone could run across the street to the Mother/Baby Hospital to get a pair of Piper forceps for use if the head got trapped.  Fortunately the forceps remained wrapped on the foot of the bed, unused.  A healthy little boy came out backwards, gently and easily.  He was immediately placed in his mother’s arms.

This episode reminded me of at least two things.  The power of prayer is one.  When I took off out the door I didn’t tell Cindy where I was going and our daughter Christie only knew that the birth center needed me for an emergency.  They had an (answered) telephonic prayer time for a good outcome in an unknown situation.  The other thing is that this is how things are supposed to work at a midwife-directed free-standing birth center.  We aim to be safe, satisfying, and seamless.  I am privileged to be part of a team that recognizes situations and rapidly responds.

The next morning I decided that the best way to prevent a recurrent unexpected breech presentation would be to buy our own pair of Piper forceps.   My first search turned up a pricey ($700) pair on a surgical instrument website.  Doctor Cheapskate then looked on ebay and found some for $42.40.  Even if it turns out that I get only one blade I can probably afford to buy the other one.  The pair will be placed in the bookcase with the natural childbirth books as a good luck charm.